North Dakota is home to many open spaces and natural areas for wildlife, natural resources, and parks, with Sioux culture at the roots of its origin. Named for a Sioux word meaning “friends” or “allies,” North Dakota is still brimming with American Indian influence and history. Bordered by Canadian provinces, snow filled mountains line the winter landscape in North Dakota, offering the opportunity for various mountain activities throughout the year.

Residents of North Dakota are served by only two health insurance companies of note. These companies are IHC Group and Medica, both of which offer a variety of plans in all regions of the state. For more information on these plans and to view pricing details, enter your zip code below and get a quote. If you need help choosing a plan or have any questions regarding health insurance, call an East Coast Health Insurance agent at 888 803 5917.


Health Status

The overall health of North Dakota has improved over the years, now ranked 12th in the nation by UnitedHealth Foundation. The positive contributions to North Dakota’s rating include a low occurrence of infectious disease, as well as a very low frequency of poor mental and physical health days among residents. There is also a high level of immunization coverage throughout the state. Moderately good statistics include an adequate number of primary care doctors throughout the state and a relatively small percentage of uninsured individuals. As the rest of the country has experienced a decline in overall health, there are health issues growing among North Dakota residents, also.

The population of obese adults has increased over the past ten years by more than 7%. Currently, there are 146,000 obese North Dakota residents over 18. Diabetes has also increased over the past decade, with 7.4% of all adults now affected by the illness. Smoking is also a prevalent part of North Dakota living, though the population has decreased over time there still remain roughly 91,000 adults smoking. It is essential to use the resources given through health insurance and public health plans for wellness and healthy eating in order to improve the health of North Dakota. Over the years, the more residents choose to stay active, the better the overall health will become.

 

Health Insurance Plans

 

IHC Group

  • Freedom Choice plans offer the choice between 70% or 80% coverage for in-network services after you meet the deductible, and a wide range of individual deductible options from $1,500 to $20,000. All Freedom Choice plans have a $50 copay for office visits with a primary care doctor or specialist, and prescription coverage subject to a separate deductible. Once the deductible is met, you can receive coverage on hospital stays, chiropractic, surgery, outpatient services, emergency care and more.
  • Freedom HDHP plans are eligible for use with a health savings account and come in a variety of high deductibles. Depending on the deductible you choose, you can pay 20% coinsurance or be covered in full after meeting the deductible amount for in-network services. Preventive care is available at no cost when using in-network providers as soon as your plan starts. Individual deductible options range from $2,000 to $10,000. All of these plans cover prescription drugs, and also give you the option of using out-of-network care.

Medica

  • Solo plans are designed for only one person and come in a range of deductibles. You can choose a plan that covers in-network services in full after deductible, or one that requires you pay 20% coinsurance. These plans provide preventive care services at no cost immediately when your plan starts, and your first three doctor’s office visits for a $20 copay. Convenience care center, urgent care and emergency room visits are also available for a copay before deductible.
  • Encore plans offer coverage for an individual and one dependent if desired for deductibles or $4,050, $6,600 or $9,150 for individuals and $6,100, $7,600 or $9,150 for a pair. These plans cover unlimited office visits and urgent care for a copay of either $20 or $40, and unlimited convenience care for $10 per visit. After deductible, these plans cover 100% of hospital services, emergency care, lab work and surgery. Other services such as prenatal care and prescription drugs are also covered.
  • Symphony plans are designed for individuals and families, with a wide range of high deductibles and 100% coverage after deductible on major medical services. As soon as your plan starts, you receive in-network office visits for a copay of $30 or $60, and preventive care at no cost. Urgent care and emergency room visits are also available for a copay before meeting the deductible. Deductibles range from $2,000 to $10,150 for individuals, and $4,050 to $20,300 for families. There is also a separate Symphony for HSA plan which offers the ability to open a health savings account.

 

 

Public Health Options

The state of North Dakota offers it uninsured, low-income residents various alternatives to a private health plan, including a state Medicaid program. Health programs are available for individuals and families who do not have insurance coverage at all or their current plans are insufficient and they cannot afford a private health plan. The state pays for most if not all services under these programs, offering assistance to various groups of people including pregnant women, disabled persons, residents over age 65, and children. In addition to Medicaid, there is also CHIP, PCIP – a high-risk health insurance plan, and services for specific diseases and conditions. For a full list of programs available in the state, visit the North Dakota Department of Human Services.

  • Medicaid: health insurance for low-income families, children, pregnant women, disabled, blind and elderly residents of North Dakota. To find out more about qualifications, read our Medicaid Eligibility by State article.
  • Healthy Steps: the Children’s Health Insurance Program (CHIP) in North Dakota for uninsured children under age 19 in North Dakota who do not qualify for Medicaid.
  • ND Immunization Program: free vaccinations in North Dakota for children eligible for the Vaccines for Children program.
  • Pre-Existing Condition Insurance Plan: medical coverage for high-risk residents of North Dakota who have been denied by private health insurance companies or uninsured for 6 months.

 

Health Insurance Laws

North Dakota private health insurers have various laws allowing them to regard individuals with pre-existing conditions in a certain way to protect themselves from paying too much. In North Dakota, insurance companies define a pre-existing condition by any condition a person has sought medical attention for in the six months leading up to their enrollment in a health plan. If an insurer decides you have a pre-existing condition, you can be denied coverage or accepted if the condition is minimal. Once accepted, an exclusion period of up to 12 months can be issued where the insurer does not pay for any care related to that condition.

Elimination riders are also allowed in North Dakota, giving the insurance company permission to never offer coverage on treating the pre-existing condition. If you are switching health insurance carriers, you can use your previous coverage as a credit to pay for care during the exclusion period, as long as you were in good standing. Adults with pre-existing conditions can also apply for a Pre-Existing Condition Insurance Plan, and receive affordable coverage without these added on exclusions. PCIPs were created by the Affordable Care Act to offer an option to individuals rejected by health insurance companies.

PCIP plans are temporary until the end of the year in 2013, and in January 2014, all adults will be able to receive coverage through the private market or a state health exchange without discrimination. The ACA will make it possible for adults with such conditions to receive health care without the use of exclusion periods and elimination riders or increased premiums. Child residents of North Dakota already have this liberty due to the ACA, as no insurer can turn down an individual under 19 with a pre-existing condition.

A law that is essential for insured individuals to be aware of is guaranteed renewability. This law helps people who pay their premiums and claims and do not violate the terms of their policy to keep their benefits. Insurance companies are required by this provision to offer to renew an individual’s health plan for another year before the year ends. Additionally, if the policy holder becomes ill after their plan’s start date, the insurance company cannot terminate their benefits. Guaranteed renewal is part of the HIPAA law, created to help protect the patient.